Provider Credentialing Specialist

20 hours ago


Phoenix, Arizona, United States LHH Recruitment Solutions Full time
Job Title: Provider Credentialing Specialist

We are seeking a highly skilled Provider Credentialing Specialist to join our team at LHH Recruitment Solutions. As a key member of our healthcare team, you will be responsible for ensuring the timely and accurate credentialing of healthcare providers.

Responsibilities:
  • Monitor and manage the credentialing process for healthcare providers, ensuring compliance with regulatory requirements.
  • Verify provider qualifications, licenses, certifications, and educational background.
  • Submit enrollment applications and monitor application statuses.
  • Prepare files for credentialing committee meetings and generate reports for credentialing status and process improvement.
  • Keep provider information up to date and communicate changes to stakeholders.
  • Coordinate with providers, insurers, and internal teams regarding credentialing.
  • Implement systematic recredentialing and monitor credential expirations.
  • Work with other departments to integrate credentialing and billing.
  • Provide training to providers and staff on credentialing processes.
Requirements:
  • Minimum of 5 years of experience in Provider Enrollment.
  • Credentialing for Hospital and Mental Health is a plus.
  • Knowledge of Medicare and Medicaid, Commercial plans.
  • Knowledge of NPPES, CAQH.
  • Ability to multi-task effectively, work individually as well as in a team environment.
  • High efficiency in problem resolution.
What We Offer:
  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A dynamic and supportive work environment.


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